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CMAS 465 Exam 1 ReviewHistory of child maltreatment and how it can be recognized at a legal and sociological perspective -
correct answer ✔✔-Child maltreatment has occurred for centuries
-In the U.S., it was widely recognized as an issue with the case of Mary Ellen.
-Sociological perspective: neighbors thought it was wrong (a social judgment that certain acts of parents
are not appropriate for cultural standards... focuses on parental actions)
-Legal perspective: legal & protective efforts and documentation of injury (based on documentable
physical injuries or emotional harm that resulted from parental actions against children... focuses of the
effects of maltreatment)
-1946: Columbia University, Radiology Professor - John Caffey: unexplained multiple fractures, subdural
hematoma - collection of blood under the skull
-1962: "Battered Child Syndrome" - Henry Kempe
-1974: Child Abuse Prevention and Treatment Act (CAPTA)
What is the battered child syndrome? - correct answer ✔✔-A clinical condition in young children who
have received serious physical abuse
-A frequent cause of permanent injury or death
-1962: Henry Kempe
-The syndrome should be considered in any child exhibiting evidence of: fracture of any bone, subdural
hematoma, failure to thrive, soft tissue swellings or skin bruising, in any child who dies suddenly, where
the degree and type of injury is at variance with the history given regarding the occurrence of the
trauma
What is the purpose of the child abuse and treatment act (CAPTA)? - correct answer ✔✔Provides federal
funding and guidance to states to support (practice):
-Prevention
-Assessments
-Investigation
-Prosecution
-Treatment
,Identifies a federal role in supporting (research):
-Research
-Evaluation
-Technical assistance
-Data collection
Sets forth the federal definition of child abuse and neglect:
-At a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in
death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which
presents an imminent risk of serious harm
What the challenges are due to the differences in the definition of child maltreatment? - correct answer
✔✔-Impacts the researchers' ability to draw a conclusion about the scope of the issue
-Difficulty in protecting children as far as investigation, intervention, and treatment
-Concern: Decisions are being made about who has and who has not committed child maltreatment
without a consistent and empirically supported definition
-Lack of social agreement on what types of parenting are acceptable versus dangerous (ex. physical
discipline/corporal punishment)
-Lack of certainty about whether child maltreatment should be characterized by adult behavior, child
outcomes, context, or more than one of these factors
-Disagreement about whether "endangerment" or "harm standards" should be included in definitions
(ex. hopskipdrive "uber for kids", kids walking home from school, latch key kids)
-Uncertainty about the appropriateness of having similar definitions of child maltreatment across legal,
clinical, and scientific fields
-Inconsistencies in definitions often preclude comparative analyses of clinical studies
What is evidence based treatment? - correct answer ✔✔-Evidence based practice is an approach to
clinical practice that calls for research, specifically quantitative experimental designs, to determine the
best clinical methods.
-Evidence impacts what you do each day
-Drawing conclusions based on the evidence
, -Based on systematic research and science
-You want to know it's going to work
-"The conscientious, explicit, and judicious use of current best evidence in making decisions about the
care of the individual patient. It means integrating individual clinical expertise with the best available
external clinical evidence from systematic research." (Sackett, D. 1996)
The four different types of empirically supported practices: - correct answer ✔✔-Well established
treatments: those that have been proven effective according to at least one randomized control trial
(RCT) following very strict experimental guidelines (Treatment must be statistically significantly superior
to a placebo or another treatment)
-Probably efficacious: treatment should be proven to be more effective than no treatment control groups
-Possibly efficacious: treatment must have at least one study showing positive results
-Experimental treatment: have not yet been tested in randomized control trial studies
What statistically significantly superior is and how is it determined? - correct answer ✔✔-Effect size will
determine if the treatment is considered effective
-Formula:
(TX Mean - Control Mean) / Control SD = Effect size
Interpreting Effect Size (Cohen 1988):
-0.20: small effect
-0.50: medium effect
-0.80: large effect (very hard to achieve)
-0.40 or higher is very impactful in psychology
Steps in the EBP Process: Clinical - correct answer ✔✔-Assess the patient/child/family: start with the
patient - a clinical problem or question arises
-Ask the question: build a clinical question derived from the issue
-Acquire the evidence
-Appraise the evidence
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